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    Aortic aneurysm
    (Galenos Yayincilik, 2007) Karakurt, Cemsit; Kocak, Guelendam; Selimoglu, Ayse; Ozen, Metehan
    [Abstract Not Available]
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    Association of cardiac changes with serum adiponectin and resistin levels in obese and overweight children
    (Lippincott Williams & Wilkins, 2013) Akinci, Aysehan; Karakurt, Cemsit; Gurbuz, Sibel; Elkiran, Ozlem; Nalbantoglu, Ozlem; Kocak, Gulendam; Guldur, Tayfun
    Objectives To investigate serum adiponectin and resistin levels in childhood obesity and their relationship with cardiac changes and insulin resistance. Methods Seventy-one obese and 24 overweight children and 40 healthy children and adolescents were selected for the study. Height and weight measurements, BMI values and BMI SD score values were obtained for each individual. After blood pressure measurement, left ventricular wall thickness, left ventricular mass, stroke volume, cardiac output, systolic and diastolic functions of the left ventricle were measured using an M-mode, two dimensional color-coded echocardiography device. Blood samples of the individuals were obtained for fasting blood sugar, total blood cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein cholesterol, high-density lipoprotein cholesterol, insulin, C-peptide, adiponectin and resistin values. Results Cholesterol and LDL values, homeostasis model assessment of insulin resistance, fasting insulin and fasting C-peptide values of the obese and overweight groups were higher (P<0.01). Adiponectin level (P<0.001) and resistin level (P<0.05) of the obese and overweight groups were lower than those of the control group (P<0.05). Echocardiographic evaluation showed diastolic dysfunction in addition to increased left ventricular wall thickness and left ventricle mass values in the obese and overweight children. We also detected a significant positive correlation among left ventricular mass, interventricular septum systolic diameter and resistin in obese children. Among the factors, resistin level was determined as an independent predictor of left ventricular mass in obese children. Conclusion In this study, even in asymptomatic obese and overweight children, cardiac structural and functional changes, such as increased left ventricular mass and diastolic dysfunction, were demonstrated. Although decreased adiponectin level was not related to cardiac changes, it was shown that decreased serum resistin levels in the obese cases lead to left ventricle hypertrophy.
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    Association of cardiac changes with serum adiponectin and resistin levels in obese and overweight children
    (Journal of Cardiovascular Medicine, 2013) Akıncı, Ayşehan; Karakurt, Cemsit; Gürbüz, Sibel; Elkıran, Özlem; Nalbantoğlu, Özlem; Kocak, Gulendam; Güldür, Tayfun; Yoloğlu, Saim
    Objectives To investigate serum adiponectin and resistin levels in childhood obesity and their relationship with cardiac changes and insulin resistance. Methods Seventy-one obese and 24 overweight children and 40 healthy children and adolescents were selected for the study. Height and weight measurements, BMI values and BMI SD score values were obtained for each individual. After blood pressure measurement, left ventricular wall thickness, left ventricular mass, stroke volume, cardiac output, systolic and diastolic functions of the left ventricle were measured using an M-mode, two dimensional colorcoded echocardiography device. Blood samples of the individuals were obtained for fasting blood sugar, total blood cholesterol, triglyceride, low-density lipoprotein (LDL) cholesterol, very low-density lipoprotein cholesterol, highdensity lipoprotein cholesterol, insulin, C-peptide, adiponectin and resistin values. Results Cholesterol and LDL values, homeostasis model assessment of insulin resistance, fasting insulin and fasting C-peptide values of the obese and overweight groups were higher (P<0.01). Adiponectin level (P<0.001) and resistin level (P<0.05) of the obese and overweight groups were lower than those of the control group (P<0.05). Echocardiographic evaluation showed diastolic dysfunction in addition to increased left ventricular wall thickness and left ventricle mass values in the obese and overweight children. We also detected a significant positive correlation among left ventricular mass, interventricular septum systolic diameter and resistin in obese children. Among the factors, resistin level was determined as an independent predictor of left ventricular mass in obese children. Conclusion In this study, even in asymptomatic obese and overweight children, cardiac structural and functional changes, such as increased left ventricular mass and diastolic dysfunction, were demonstrated. Although decreased adiponectin level was not related to cardiac changes, it was shown that decreased serum resistin levels in the obese cases lead to left ventricle hypertrophy.
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    Blood pressure is normal, but is the heart?
    (Springer, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, Saim
    There is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.
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    Blood pressure is normal, but is the heart?
    (Sprınger, 233 sprıng st, new york, ny 10013 usa, 2018) Celik, Serkan Fazli; Karakurt, Cemsit; Tabel, Yilmaz; Elmas, Taner; Yologlu, Saim
    There is no detailed strain analysis of cardiac functions in treated hypertensive pediatric patients. The aim of this study was to evaluate the cardio-protective effects of different drug classes in treated pediatric hypertensive patients. Sixty non-obese-treated hypertensive patients with preserved left ventricular (LV) systolic function and 45 age-, sex-, and body mass index-matched healthy subjects underwent clinical evaluation, including 24-h ambulatory blood pressure monitoring, standard echocardiographic examination, tissue Doppler imaging, and two-dimensional Speckle Tracking Echocardiography. The patients were divided into two subgroups based on the effects of the drugs on the Renin Angiotensin Aldosterone System. The subgroup hypertension (HT) 1 received angiotensin-converting enzyme inhibitor or angiotensin receptor blocker, and HT 2 subgroup received calcium channel blocker, beta-blocker, or diuretics. There was no difference between the two groups and subgroups with respect to clinical, demographic, ABPM, ventricular volumes, ejection fraction, and tissue Doppler imaging (TDI) parameters. For patients and controls, respectively, global longitudinal strain was - 18.70 +/- 3.41 versus - 21.01 +/- 3.82 (P < 0.001), and global radial strain was 40.6 +/- 9.8 versus 54.8 +/- 12.8 (P = 0.004). Peak LV twist and peak LV torsion were not significantly different. The patient subgroup analyses with each other revealed no difference in systolic and diastolic myocardial deformation properties. Strain parameters were reduced in all treated hypertensive children compared to normotensive children, and the various cardiac mechanic parameters were similarly abnormal no matter what type of antihypertensive agent was used.
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    CARDIOPROTECTIVE AND ANTIOXI DAN ACTIVITY OF BLUEBERRY ANTHOCYANINE AND POLYPHENOLS IN RATS
    (Elsevier Science Bv, 2009) Karakurt, Cemsit; Gursoy, Sule; Alagoz, Mehmet Abdullah; Karakurt, Arzu; Aktays, Goknur; Kocak, Gulendam
    [Abstract Not Available]
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    A case of cardiac cyst hydatid with multiple system involvement
    (2021) Dogan, Gulec Mert; Dogan, Sait Murat; Tasolar, Sevgi; Okut, Gokalp; Sigirci, Ahmet; Elkiran, Ozlem; Karakurt, Cemsit
    The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonly affected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac, lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On the thoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodular lesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Most cases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reported cases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in the presence of cardiac hydatid cyst, treatment should be surgery.
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    A case of cardiac cyst hydatid with multiple systeminvolvement
    (2021) Dogan, Gulec Mert; Dogan, Sait Murat; Taşolar, Sevgi; Okut, Gokalp; Sığırcı, Ahmet; Elkiran, Ozlem; Karakurt, Cemsit
    The larval form of the Echinococcus granulosus causes cystic echinococcosis. The liver and the lungs are the most commonlyaffected organs. Echinococcosis can also be present in other organs although it is rare. We reported a case with sacral bone, cardiac,lung and liver involvement. Clinical and radiological findings of this unique case were discussed. At the Thoracic Computed On thethoracic computed tomography (CT) scan of a 16-year-old female patient was seen multiple parenchymal and subpleural nodularlesions and a cystic mass in the right ventricular cavity. Echocardiographic examination of the patient also observed on CT. Mostcases of cardiac cystic echinococcosis were occurred on adult patients, while only 20 cases were in children. For the 20 reportedcases in children, there were 9 cases of cardiac echinococcosis involving left ventricle. Because of the possible complications in thepresence of cardiac hydatid cyst, treatment should be surgery.
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    A case with pyopericardium and cardiac tamponade induced by migration of ventriculoperitoneal shunt catheter
    (Baycinar Medical Publ-Baycinar Tibbi Yayincilik, 2014) Karakurt, Cemsit; Celik, Serkan Fazli; Ozturk, Mehmet; Disli, Olcay Murat; Yakinci, Cengiz
    Ventriculoperitoneal (VP) shunt is a method used in the treatment of hydrocephalus. In this article, we report a four-year-old girl who was implanted a VP shunt due to hydrocephalus, and referred to our clinic due to dyspnea and cardiomegalia. Echocardiographic examination revealed cardiac tamponade and pericardial effusion. Thorax computed tomography, which was performed due to suspicion of migration of the VP catheter to the pericardium, showed that the VP catheter tip was inside the pericardium. Pericardiectomy was performed due to pericardial constriction was developed after tube drainage, and the VP shunt catheter was shortened and replaced into the abdominal cavity.
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    Closure of Patent Ductus Arteriosus in Children, Small Infants, and Premature Babies with Amplatzer Duct Occluder II Additional Sizes: Multicenter Study
    (Wiley-Blackwell, 2013) Sungur, Metin; Karakurt, Cemsit; Ozbarlas, Nazan; Baspinar, Osman
    ObjectivesTo evaluate safety and efficacy of closure of patent ductus arteriosus (PDA) with Amplatzer duct occluder II Additional Sizes (ADO II AS) and to report early and midterm results of the device in children and very young symptomatic infants. MethodsRetrospective analysis of angiographic data of 60 children from four pediatric cardiology centers. ResultsThe median patient age and weight were 6.5 (0.5-168) months and 6.8 (1.19-57) kg, respectively. In the study, 26 children had a body weight of 6 kg. Of these 26 children, 9 had a body weight of 3 kg. The median narrowest diameter of PDA was 2 (1.2-4) mm. Ductal anatomy was Type A in 29, Type B in 2, Type C in 11, Type D in 1, and Type E in 16 patients, and a residual PDA after surgery in 1 patient. Closure with ADO II AS was achieved in 58 (96.6%) of 60 attempted cases. In two infants, the device was not released because of significant residual shunt. ADO II was used in one, and the other was sent to surgery. Complete closure was observed in all ADO II AS deployed children by the next day on echocardiography. Median follow-up was 12 (1-18) months. Neither death nor any major complications occurred. ConclusionsOur study shows that closure of medium and small sized PDA by using ADO II AS device is effective and safe in children. The use of the device will expand the field of application of PDA closure in small infants. (c) 2013 Wiley Periodicals, Inc.
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    Combined (dual) drug therapy for the treatment of patent ductus arteriosus: last approach prior to ligation
    (Cambridge Univ Press, 2023) Deveci, Mehmet F.; Kaya, Huseyin; Yurttutan, Sadik; Alagoz, Meral; Gokce, Ismail K.; Karakurt, Cemsit; Gullu, Ufuk U.
    Objective: We aimed to evaluate the efficacy of combined (ibuprofen+paracetamol) medical therapy in cases of persistent haemodynamically significant patent ductus arteriosus that are resistant to standard medical monotherapy (ibuprofen and/or paracetamol) in this retrospective multi-centre study. Methods: The combined therapy included the administration of 15mg/kg/dose of paracetamol every 6 h for 3 days and ibuprofen at an initial dose of 10mg/kg/dose followed by 5 mg/kg/dose every 24 h. After 2 days following the administration of the last dose, the researchers evaluated the efficacy of combined treatment by conducting an echocardiographic examination. Results: Of all 42 patients who received combined therapy, 37 (88.1%) patients exhibited closure of the haemodynamically significant patent ductus arteriosus without requiring surgical ligation. Patients who did not respond to combined therapy had a higher mean birth weight and gestational age compared to those who responded (p < 0.05). Conclusion: The researchers believe the success of ibuprofen and paracetamol in haemodynamically significant patent ductus arteriosus treatment may be due to their synergistic efficacy and inhibition of the prostaglandin synthesis pathway through different enzymes. The results of our retrospective trial suggest that combination therapy with paracetamol and ibuprofen can be attempted when monotherapy is unsuccessful in treating haemodynamically significant patent ductus arteriosus, especially in centres without a surgical department.
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    Combined effect of aerosolized iloprost and oxygen on assessment of pulmonary vasoreactivity in children with pulmonary hypertension
    (TURKISH SOC CARDIOLOGY,, 2014) Elkiran, Özlem; Karakurt, Cemsit; Kocak, Gulendam
    Objective: The evaluation of pulmonary vascular reactivity plays a significant role in the management of patients with pulmonary hypertension. Inhaled nitric oxide in combination with oxygen (O-2) has become widely used as an agent for pulmonary vasodilator testing. However, inhaled nitric oxide is not available in many developing countries. Recently, aerosolized iloprost was suggested as an alternative to nitric oxide for this purpose. In the present study, aerosolized iloprost was used together with O-2 in the pulmonary vasoreactivity test of children with severe pulmonary hypertension. Thus, the synergistic effect of both vasodilators was utilized without extending the duration of cardiac catheterization. Methods: The prospective cohort study registered a total of 16 children with severe pulmonary hypertension whose median age was 4.5 years. Hemodynamic parameters were quantified before and after the vasoreactivity test. Increased left-to-right shunt, pulmonary vascular resistance of <6 Woods units (WU)/m(2) and a pulmonary-systemic resistance ratio of <0.3, as well as a decrease >10% in the pulmonary vascular resistance and pulmonary-systemic vascular resistance ratio after the vasoreactivity test were accepted as a positive response. The data were analyzed using Wilcoxon signed-rank and the Mann-Whitney U tests. Results: Eleven children gave a positive response to the vasoreactivity test, while 5 children did not respond. Pulmonary vascular resistance dropped from 9.98 +/- 1.39 WU/m(2) to 5.08 +/- 1.05 WU/m(2) (p=0.013) and the pulmonary-systemic vascular resistance ratio fell from 0.68 +/- 0.08 to 0.32 +/- 0.05 (p=0.003) in the children who were responsive. No side effects were observed related to iloprost administration. Conclusion: Administration of inhaled iloprost in combination with O-2 for pulmonary vasoreactivity testing can be useful for correctly identifying pulmonary vasoreactivity without extending the duration of cardiac catheterization.
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    Congenital Heart Disease and COVID-19: A Single-Center Experience
    (Briefland, 2022) Oncul, Mehmet; Karakurt, Cemsit; Elkiran, Ozlem; Gozukara, Harika Gozde
    Background: Coronavirus disease 2019 (COVID-19) has been infecting children since December 2019 and has caused a severe epidemic and millions of deaths worldwide. COVID-19 has severe clinical effects and is more complicated to manage in patients with underlying diseases, such as congenital heart disease (CHD), past surgical operations, arrhythmia, and end-organ damage. Objectives: This study aimed to evaluate the clinical course, follow-up, and treatment process of patients with CHD and COVID-19 in Inonu University Faculty of Medicine, Department of Pediatrics, Turkey during March 2020-February 2021. Methods: This retrospective study was performed on patients with CHD and COVID-19 in the Department of Pediatrics at Inonu University Faculty of Medicine during March 2020-February 2021, selected by making full count sampling. Admission complaints, clinical findings, biochemical parameters, echocardiography results, hospitalization times, treatments, and clinical follow-up findings were retrieved from patients' files. Results: 11 patients with underlying CHD and COVID-19 were evaluated retrospectively during the study. Ten patients were hospitalized and treated due to COVID-19. Treatment of seven of these patients continued in the intensive care unit (ICU), and five were followed up under a mechanical ventilator. Two patients died during follow-up in the ICU. Conclusions: The clinical course of COVID-19 is severe, and the mortality rate is high in patients with serious diseases, such as underlying CHD. Therefore, COVID-19 in patients with CHD requires more serious and careful follow-up.
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    Due of a Ascending-to-Descending Aortic Bypass for Complex Coarctation of the Aorta
    (Derman Medical Publ, 2013) Battaloglu, Bektas; Disli, Olcay M.; Akca, Baris; Karakurt, Cemsit; Erdil, Nevzat
    A variety of approaches and surgical techniques have been proposed for the management of complex form of aortic coarctation. When there is an additional cardiovascular disorder that requires surgical correction it is preferable to correct both lesions through the same incision simultaneously. In this paper, we describe the technique of ascending-to-descending aorta bypass grafting performed through the median sternotomy and simultaneous additional cardiovascular disorders repair in a case who had complex aortic Coarctation.
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    Effect of Piracetam and Iron Treatment on Heart Rate Variability in Patients With Breath-Holding Spell
    (Elsevier Science Inc, 2024) Oncul, Mehmet; Elkiran, Ozlem; Karakurt, Cemsit; Gungor, Serdal; Maras, Serdar Akin; Bag, Harika Gozde Gozukara
    Background: Breath-holding spells are a benign condition primarily seen in 3% to 5% of healthy children aged between six months and five years. Although no specific treatment is recommended due to its benign nature, iron and piracetam are used in severe or recurrent cases. We planned to compare the heart rate variability (HRV) before and after treatment with 24 -hour Holter monitoring in patients receiving iron and piracetam treatment and investigate the treatment's effectiveness. Methods: Twenty-five patients who applied to the outpatient clinic between 2013 and 2015 due to breath-holding spells were included in the study. The patients who received piracetam and iron therapy and underwent 24 -hour rhythm Holter monitoring were evaluated retrospectively. Results: Fourteen (56%) of these patients were evaluated as having cyanotic-type and 11 (44%) patients were assessed as having pale -type breath-holding spells. A significant difference was found only between hourly peak heart rate and total power in the group receiving iron treatment. Significant differences were also found among the minimum heart rate, mean heart rate, the standard deviation of RR intervals, the mean square root of the sum of the squares of their difference between adjacent RR intervals, spectpow, and low frequency before and after the treatment in the patients who started piracetam treatment ( P < 0.05). Conclusions: Our study is critical as it is the first to investigate the effects of treatment options on various HRV in patients with breath-holding spells. There were statistically significant changes in HRV parameters in patients receiving piracetam, and the number of attacks decreased significantly. Piracetam treatment contributes positively to the breath-holding spell with regard to efficacy and HRV, therefore it can be used to treat breath-holding spells. (c) 2024 Elsevier Inc. All rights reserved.
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    Evaluation by N-terminal Prohormone of Brain Natriuretic Peptide Concentrations and Ross Scoring of the Efficacy of Digoxin in the Treatment of Heart Failure Secondary to Congenital Heart Disease With Left-to-Right Shunts
    (Springer, 2013) Elkiran, Ozlem; Sandikkaya, Ayse; Kocak, Gulendam; Karakurt, Cemsit; Taskapan, Cagatay; Yologlu, Saim
    This study aimed to evaluate the effectiveness of digoxin in children with heart failure secondary to left-to-right shunt lesions and normal left ventricular systolic function. The study registered 37 such patients (ages 10 days to 24 months, groups 1 and 2) and used 20 healthy children as a control group (group 3). Left ventricular systolic function, as assessed by conventional echocardiography, was normal in all the subjects. Congestive heart failure was diagnosed by clinical evaluation and modified Ross scoring. Plasma N-terminal prohormone of brain natriuretic peptide (NT-proBNP) concentrations and complete blood counts were assessed in all the children. Group 1 was treated with digoxin, enalapril, and furosemide and group 2 with enalapril and furosemide. Approximately 1 month after starting treatment, the patients were reevaluated by physical and echocardiographic examinations, modified Ross scoring, plasma NT-proBNP concentrations, and complete blood counts. The pre- and posttreatment Ross scores of group 1 (p = 0.377) and group 2 (p = 0.616) did not differ significantly. The NT-proBNP values in both groups decreased after treatment (p = 0.0001). The pre- and posttreatment NT-proBNP values did not differ significantly in group 1 (p = 0.094)) and group 2 (p = 0.372). The pretreatment NT-proBNP values in groups 1 and 2 (p = 0.0001) were significantly higher than in the control group (p = 0.003). A smaller difference was observed between posttreatment NT-proBNP values in group 1 and the control group (p = 0.045). We found no significant difference between the posttreatment NT-proBNP values of group 2 and those of the control group (p = 0.271). The study showed that both treatments currently used to treat heart failure secondary to congenital heart disease with left-to-right shunts and preserved left ventricular systolic function are effective and do not differ significantly. Thus, digoxin does not provide any extra benefit in the treatment of such patients.
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    An evaluation of risk factors, clinical features, and follow-up findings of patients with infective endocarditis
    (2021) Oncul, Mehmet; Karakurt, Cemsit; Elkiran, Ozlem
    Aim: Infective endocarditis (IE) is a serious infection of the endocardial layer of the heart and the endothelial layer of the aorta, which usually is caused by bacteria or fungal microorganisms, requiring early diagnosis and treatment. Congenital heart diseases (CHD) and acquired valvular diseases are risk factors for IE. Advances in life-saving medical interventions such as intensive care, immunosuppressive treatments and the more frequent use of implanted prosthetic materials have increased the risk of IE. The aim of this retrospective study is to evaluate the underlying risk factors, clinical and laboratory findings, microbiological profiles, treatments, and follow-up of patients diagnosed with IE in our clinic. Material and Methods: In this retrospective study, risk factors, clinical features, laboratory findings, microbiological characteristics, echocardiographic features and medical treatment results and complications of 7 patients who admitted to Inonu University Faculty of Medicine Pediatric Cardiology Department a diagnosed with IE, between 2013-2019 were evaluated. Results: Seven patients who were diagnosed with IE were detected from the hospital data system. When the predisposing causes were examined, we found that 3 patients had mitral insufficiency due to rheumatic heart disease, and 3 patients had CHD. None of our patients had a history of intervention before infective endocarditis. Bacteria grew in blood cultures of all patients. The most grown microorganisms were Staphylococci. Surgical treatment, valve repair or replacement therapy, was applied to three patients. A patient, who had aortic coarctation and mycotic aneurysm developing based on infective endarteritis, died on the 5th day due to aneurysm rupture while waiting for surgery under antibiotic pressure. Conclusion: Despite advancing treatment modalities, the mortality rate is about 25%, which is still too high. The most common bacterial infections that cause IE are Streptococci and Staphylococcal infections. Since mortality and morbidity rates are too high in IE, in case of suspicion, necessary laboratory tests and blood cultures should be taken, and treatment should be started immediately.
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    Evaluation of the left ventricular function with tissue tracking and tissue Doppler echocardiography in pediatric malignancy survivors after anthracycline therapy
    (Wiley, 2008) Karakurt, Cemsit; Kocak, Gulendam; Ozgen, Unsal
    Although the anthracyclines have gained widespread use in the treatment of childhood hematological malignancies and solid tumors, cardiotoxicity is the major limiting factor in the use of anthracyclines. The aim of this study was to assess the mitral annular displacement by tissue tracking in pediatric malignancy survivors who had been treated with anthracycline groups chemotheraphy and compare with the tissue Doppler and conventional two dimensional measurements and Doppler indices. In this study, 32 pediatric malignancy survivors and 22 healthy children were assessed with 2D, colour-coded echocardiography. Left ventricular ejection fraction, fractional shortening, stroke volume, cardiac output, cardiac index and diastolic functions were measured. All subjects were assessed with tissue Doppler echocardiography, mitral annular displacements, and also with tissue tracking method. We detected that peak velocity of the early rapid filling on tissue Doppler (E') was lower (p < 0.05) and the ratio of early peak velocity of rapid filling on pulse Doppler to tissue Doppler (E/E') values were statistically higher in patient group than control group (p < 0.05). Myocardial performance index values were also higher in patient group than the control group (p < 0.01). It appears that MPI is a useful echocardiograghic method than tissue tracking of mitral annular displacement in patients with pediatric cancer survivors who had subclinical diastolic dysfunction.
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    Huge Left Atrial Pseudoaneurysm in a 5-Month-Old Baby Presented with Supraventricular Tachycardia
    (Taiwan Soc Cardiology, 2016) Karakurt, Cemsit; Turkoz, Riza; Saritas, Bulent; Celik, Serkan; Elkiran, Ozlem
    Cardiac pseudoaneurysm is an extremely rare condition in children. It can be congenital or acquired and has been primarily described in the left side of the heart. The congenital form of pseudoaneurysm is thought to be related to muscular dysplasia of the muscular layer of the heart. The acquired form is related to myocardial infarction, infective endocarditis or chest trauma. In this report we described a 5-month-old baby with left atrial pseudoaneurysm who was referred to our hospital due to tachycardia and hemodynamic instability. After diagnosis of left atrial pseudoaneurysm, aneurysmectomy was performed and the left atrial wall was successfully repaired by surgery three days after admission. In conclusion, due to life threatening complications such as dissection, arrhythmias, compression of aneurysm and tromboembolic complications, pseudoaneurysm should be treated by surgery.
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    Is edema in minimal change disease of childhood really hypovolemic?
    (Springer, 2008) Tabel, Yilmaz; Mungan, Ilke; Karakurt, Cemsit; Kocak, Gulendam; Gungor, Serdal
    Objectives In this study, we aimed to find out whether children with minimal change disease can be classified as hypervolemic by objective measures. Methods Eighteen children with minimal change disease diagnosed at our department between November 2005 and May 2007 were included in this study. All patients were newly diagnosed or relapsed but were steroid free for at least 6 months. In the first week of edema and when edema resolved (5-7 days after initiation of therapy), weight, height and blood pressure were obtained from all patients. Serum and plasma samples were taken following a starvation period of 12-14 h. The volume load of all patients was evaluated, measuring the inferior vena cava indices in each stage by echocardiography. Results Average weight at presentation was 8.5% higher than the ideal (dry) weight. There were significant differences between the first and post-treatment body weights, abdomen circumference, and systolic and diastolic blood pressure values (P < 0.05 for each). The inferior vena cava index (IVCI) values decreased significantly after diuretic treatment (P < 0.001), while inferior vena cava collapsibility index (IVCCI) values increased in the post-treatment period (P < 0.001). Conclusion We believe that a close follow-up of hypervolemic children with MCD, treated solely with easy-to-handle diuretics instead of I.V. albumin and diuretics may properly solve the edematous state in these patients.